Am I Wrong for Telling Him to Leave?

I don't even know how to begin this post. I've been sitting here for several minutes, staring at the blank page in front of me, and the blinking cursor—seemingly hungry for letters—is starting to irritate me. I have so much to say, but I don't know how to begin without being misunderstood. Perhaps the easiest thing is simply to start telling you the story and see where my thoughts take me.

What I want to tell you about happened today in my office. I spent some time wondering whether I really wanted to talk about it, but I believe I do. When I started this project, I set out to be honest and open. That means also talking about things that bother me or that most people would prefer to keep hidden.

Today, I dealt with a dissatisfied patient. Not dissatisfied in the ordinary sense—perhaps everyone is dissatisfied to some extent—but dissatisfied to the point that he had to leave my office and was advised to find another doctor.

After a long day with many patients, each with a case more or less difficult, I had the chance, at the end of my working day, to see a young patient who came in with a relatively minor problem. I don't intend to give any further details, so as not to compromise his identity, but I can tell you that his expectations were completely misguided.

First of all, medically speaking, what he was asking for made no sense whatsoever. Even if I had given him what he wanted, it would have achieved nothing. Despite my explanations, he kept jumping from one request to another like a horseman at full gallop, as though he were constantly coming up with new backup plans.

Judging by how he reacted to what I was telling him, I believe he saw things entirely differently. In his mind, he knew better, and my disapproval only made him feel as though he were being cheated. The discussion reached its climax when he told me he wasn't there to waste his time.

My calm reply came very quickly: "Neither do I want to waste my time."

What do you think a reasonable person might say in that situation? What would you say? You go to the doctor wanting something specific from them. They haven't refused yet, and they haven't told you that you won't get what you're asking for. But you can see they're trying to explain why what you want won't work. What do you do then? What would you do?

Of all the possible answers he could have given—including saying nothing at all—he chose to say: "You're being paid right now. You're making money! I'm not."

I think it took me a little over twenty seconds to truly start boiling inside. What exactly was that supposed to mean? Should I thank him for the fact that I earn money? Do I earn money because of him? Or, more to the point, if he's paying me, does that mean I should do whatever he wants?

Somehow, what he said reminded me of all those idiots I see telling police officers, "You're paid with my tax money," as though the police worked directly for them. That was roughly how I felt at the time.

His next move was to return to what I'd been trying to explain to him a few minutes earlier—why what he was asking for wouldn't work. You cannot imagine how surprised he was when I looked at him calmly and said, "I no longer have the energy for this discussion."

He stood up and left without waiting for me to say anything else. Shortly afterward, he was advised to find another doctor.

There's nothing new about someone arriving with absurd medical expectations, nor about them becoming dissatisfied when they don't get what they want. What was new to me today—and particularly offensive—was having someone throw it in my face that I was making money from his consultation. As though I were nothing more than a prostitute—with no intention of insulting prostitutes—and that, because he was paying me, he could demand whatever he wanted.

When did this kind of mentality become normal?

Fortunately, cases like this are extremely rare. For me, this was the first in fourteen years of medical practice. But now I'm trying to understand, objectively and without the emotions I felt at the time, what's actually going on. I want to understand what makes him think this way and why he believes he can speak to someone like that.

My immediate reaction is to think he's an idiot and not waste any more time on him. Does that make me a bad doctor? Should I feel guilty for telling him to get lost? But if I let him remain my patient, where do I draw the line when it comes to respect? Why should I accept being spoken to like that?

When you go to someone for help with a particular problem, what makes you arrogant enough to dismiss the possibility of losing that help?

I might expect this kind of attitude from a multimillionaire. Have you seen those wealthy old men from Monaco on YouTube, walking arm in arm with eighteen-year-old women? The kind of people who believe they can do anything without facing consequences? I'd expect this kind of arrogance from someone like that. I wouldn't tolerate it from him either, but at least I could understand where it came from. From an ordinary person, though, probably not.

Now, those of you reading this in America will probably come after me and tell me that entitlement is common. Personally, I had never encountered it professionally in my office until today.

At the moment, I'm experiencing something of an internal conflict. On one hand, the man is an idiot who has no place in my office. On the other, I wish I could rise above these thoughts. I'd like to be able to move past it and attribute his reaction to the situation he was in, or to whatever worries he probably carries. I'd very much like to be the bigger person and let it go.

But as soon as those thoughts enter my mind, a little devil appears and calmly asks me: "Are you stupid? Do you really want to let people walk all over you? Since when do you have to justify yourself like this?"

My decision regarding him remains unchanged. Still, I can't help wondering where the line lies between being understanding toward a patient and losing your self-respect by accepting anything from them. At the same time, I wonder what drives people to behave this way.

Karma is so strange sometimes. Today it comes right after I just wrote, these past few days, about good doctor-patient communication. If you ask either of us, neither of us had good communication today.